A dorsal approach for the removal of the nasal septum in the horse

OBJECTIVE: To describe and evaluate a technique involving a dorsal approach for the removal of the nasal septum in adult horses. STUDY DESIGN: Retrospective clinical study. ANIMALS: Four client-owned horses. METHODS: Access for partial nasal septum resection was through a dorsal nasal bone flap. Septum resection was performed because of reduced airflow from septal deviation and/or thickening caused by traumatic insult or neoplasia. Preoperative clinical signs and diagnostic results were recorded. Intra- and postoperative complications were noted and follow-up information was obtained from telephone interviews of owners or by clinical examination. RESULTS: The abnormal segment of the nasal septum was completely removed in all horses. A dorsal nasal bone flap approach provided excellent access to the septum and allowed immediate control of hemorrhage; blood transfusion was not needed. Cosmetic results were considered good to excellent by owners and horses returned to their previous level of work without perceived limitations associated with airway function. CONCLUSIONS: Nasal septum resection by the dorsal approach permits good observation of the abnormal septum, and provides exposure that facilitates removal of nasal masses and reduction of depression fractures with minimal complications. CLINICAL RELEVANCE: A dorsal nasal bone flap approach should be considered for horses that require nasal septum resection because it can be achieved with minimal hemorrhage, good cosmetic results, and return to function.     

Fixation of chronic suture exostosis in a mature horse

This case report describes the clinical findings, diagnosis and treatment of a 14‐year‐old Warmblood gelding with suture exostosis. The horse was referred to our clinic because of bilateral swelling in the region of the frontal and nasal bone junction and bilateral epiphora. Epiphora was the main concern for the owner and the reason for further investigation and treatment. Radiographic examination showed extensive bone proliferation on the dorsal frontal and nasal bones. Computed tomographic (CT) images further characterised the periosteal proliferation as new bone formation and localised it along the frontonasal and frontolacrimal suture lines. Computed tomographic images also showed pathological changes of both lacrimal ducts. A chronic fracture was suspected to be the cause of the periosteal proliferation, and surgical treatment using 2 small 2.4 Unilock plates was chosen to stabilise the suture between the frontal and nasal bones. The swelling decreased and the epiphora resolved by 6 months post operatively. A CT examination 2 years later showed complete healing.     

Extensive nasal septum resection in horses using a 3-wire method

OBJECTIVE: To describe a surgical technique for, and report outcome after, extensive nasal septum resection in horses with congenital or acquired septal diseases. STUDY DESIGN: Retrospective study. ANIMALS: Horses (5) with nasal septal deformity. METHODS: Under general anesthesia, obstetrical wires were preplaced around the ventral, caudal, and dorsal aspects of the nasal septum by combinations of manual guidance (ventral and caudal wires) and use of a trephine hole on the dorsal mid-line (dorsal and caudal wires). The rostral part of the septum was incised with a scalpel and the ventral, dorsal, and caudal septal incisions were made with the preplaced wires. After septum removal, the nasal cavity packed with a tampon and a temporary tracheotomy was performed. RESULTS: The diseased nasal septum was completely removed in all horses. It was possible to direct the caudal cut at a sufficient angle so that the remaining stump was in a wide part of the nasal passage, where it would have minimal effect on airflow. Four horses healed, and returned to intended use but continued to make a slight respiratory noise during exercise. At 13 months after surgery, 1 horse with a concurrent wry nose was retired from race training after 2 additional surgeries failed to relieve exercise intolerance at high speed. CONCLUSIONS: The 3 wire-cut method of nasal septum resection was technically easy to perform and safe, allowed return to function in most horses, and produced an excellent cosmetic appearance. CLINICAL RELEVANCE: This technique for nasal septum resection allows removal of a large portion of the nasal septum and provides a safe alternative to conventional techniques of nasal septum resection in the horse.     

Suture exostosis causing obstruction of the nasolacrimal duct in three horses

CASE HISTORY Three horses were presented with facial swelling and epiphora.

CLINICAL FINDINGS: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture.

DIAGNOSIS: Lacrimomaxillary suture exostosis.

CLINICAL RELEVANCE: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retrograde and normograde, may be used as an aid to diagnosis.     

Imaging diagnosis--nasofrontal suture exostosis in a horse

A 14-year-old Quarter Horse had chronic facial swelling and a more recent history of progressive bilateral epiphora. Radiographic findings were compatible with exostosis of the nasofrontal suture. Computed tomography (CT) of the head, including CT dacryorhinocystography, confirmed the diagnosis and allowed presurgical planning of resection of the exostosis, which resulted in resolution of the clinical signs.     

Occurrence of a vaginal septum in a foal diagnosed with pyometra

A 10-week-old Westphalian filly was presented for vaginal discharge of 14-days' duration. Examination revealed a partial vaginal septum and pyometra. Two Group B streptococcal pathogens (Streptococcus dysgalactiae subspecies equisimilis and Streptococcus equi subspecies zooepidemicus) were isolated from the uterus. Pyometra was successfully treated using endoscopically facilitated removal of intraluminal exudate and locally and systemically administered antimicrobials. The filly was reported to be progressing well at 12 months following treatment with no further evidence of disease. Pyometra has not been previously reported in foals, and vaginal septum is evidently rare in this species. These abnormalities should be considered when young fillies develop purulent vaginal discharge.     

A tumour of vascular origin in a horse

Tumours of vascular origin are uncommon in horses. This report describes the surgical treatment of a large subcutaneous tumour in a Quarter Horse colt. The histopathological appearance of the mass was most consistent with a haemangioma. While these neoplasms of vascular origin are often difficult to characterise, it has been suggested that there is a continuum of types with some cases falling between the categories. Further classification of vascular tumours requires special stains and immunohistochemical techniques.     

Visual evidence of progression and eventual resolution of nasofrontal suture exostosis over 27 months in a gelding

A 22-year-old Thoroughbred gelding presented with a noticeable external firm and nonpainful swelling over the location of the frontal sinuses. Further radiographic investigation of the swelling identified soft tissue facial swelling, new bone formation and a radiolucent line between two areas of bone remodelling. The horse was diagnosed with a nasofrontal suture exostosis. This is a relatively rare disease of the head but is one of the more common reasons for facial swelling. It is reported that these horses are not painful and that the swelling and bony reaction will resolve over 12–18 months with no treatment needed. It is well described in the current literature what the initial presentation should look like; however, there is a void when it comes to demonstration of the clinical course of the disease. This report provides veterinarians and owners with a visual reference to a relatively typical course of disease, where swelling can enlarge over time and still resolve within 2 years.     

Fibromatous epulis in a Campolina horse

An 11-year-old Campolina horse was referred to the Veterinary Hospital due to the presence of an exophytic mass located in the rostral region of the mandible. Radiographic evaluation showed no evidence of tumour infiltration in the underlying mandibular bone, and the histopathology and immunohistochemical evaluations confirmed the diagnosis of fibromatous epulis. The treatment included surgical excision of the mass, followed by extensive curettage of the underlying mandibular bone. Complete healing of the wound was evidenced 60 days after the procedure; however, relapse was reported by the owner between 1 and 3 years after surgery.     

Laryngeal neuroendocrine tumour in a horse

A 13‐year‐old Quarter Horse mare was presented to the Ontario Veterinary College Teaching Hospital with chronic progressive respiratory noise and exercise intolerance. Severe respiratory stridor associated with a laryngeal mass was seen on upper airway endoscopy. Ultrasonography revealed an intra‐cartilagenous mass and allowed for a guided biopsy. Histological analysis of the mass characterised a neuroendocrine tumour and the mare was subjected to euthanasia due to the poor prognosis. Ultrasound examination was paramount in making the diagnosis and facilitating the biopsy. To our knowledge, neuroendocrine tumours have not previously been reported in the equine larynx.     

Mandibular squamous cell carcinoma in a young horse

Squamous cell carcinoma (SCC) is a frequently reported neoplasm in the horse. However, oral forms are uncommon and represent only 7% of all SCC. A literature review reveals a total of 13 cases of oral SCC with no apparent sex or breed predisposition but predominantly adult and old horses, mean age 16.5 years. This case report describes a 3.5-year-old pony filly that was presented for investigation of a mandibular fistula of 3 weeks' duration. The clinical and histopathological findings of mandibular squamous cell carcinoma in this filly are described in detail.     

Osteosarcoma in the femur of a horse

A 27-year-old Arabian pony gelding presented for evaluation of weight loss, intermittent sheath oedema, persistent neutropenia and thrombocytopenia, and acute left hindlimb swelling and gait abnormality. Clinical findings included swelling, heat and sensitivity localised over the left greater trochanter, mild to moderate ventral and sheath oedema, a left hindlimb post-legged gait, and off-loading of weight from the left hindlimb at rest. Initially, neutropenia and thrombocytopenia were confirmed on bloodwork, but neutrophilia and thrombocytopenia persisted as the case progressed. Diagnostic imaging (radiography and percutaneous ultrasonography) of the left hindquarters revealed an aggressive, mixed proliferative and lytic bony lesion of the proximal left femur as well as associated muscle fibre disruption and a soft tissue mass. A percutaneous core biopsy of the lesion led to the diagnosis of osteoblastic osteosarcoma on histopathology. Pain and inflammation associated with the lesion was medically managed in the hospital with mild improvement. Additionally, palliative radiation was performed under general anaesthesia. Unfortunately, before a response to palliative radiation could be assessed, the patient was subjected to euthanasia due to development of acute neurological signs.     

An undifferentiated sarcoma in the cervical region in a horse

An Italian Saddle Horse mare was admitted for a hard, nonpainful mass localised in the cervical region. Clinical and diagnostic investigations were performed, which were suggestive of a multilobulated ossifying mass of neoplastic origin. Due to poor prognosis the horse was subjected to euthanasia. Post mortem computed tomography, anatomopathological examination and immunohistochemistry were used to make a definitive diagnosis of undifferentiated sarcoma in the cervical region.     

Paravertebral malignant peripheral nerve sheath tumour (MPNST) in a horse

A 10‐year‐old Lipizzaner gelding was presented with intermittent ataxia and hindlimb weakness. Ultrasonographic examination identified a mass cranial to the tuber sacrale. A provisional diagnosis of a soft tissue sarcoma was made based on a biopsy specimen. Owing to the extensive nature of the tumour and the associated poor prognosis, the horse was subjected to euthanasia on humane grounds. A post mortem examination revealed a locally infiltrative soft mass within the left lumbosacral epaxial musculature. Histologically, an infiltrative neoplasm predominantly composed of pleomorphic spindle or stellate‐shaped cells was identified. Neoplastic cells exhibited strong S‐100 protein and GFAP expression and variable vimentin, NSE, NGFR and myoglobin expression. They were uniformly negative for pan‐cytokeratin, melan A, laminin and desmin. The ultrastructural examination revealed pleomorphic cells with long cytoplasmic processes and an absence of melanosomes. Based on these results, a diagnosis of malignant peripheral nerve sheath tumour was made. This report contributes further information to assist in the diagnosis of these poorly defined neoplasms in animals, especially when they occur in uncommon locations.     

Metastatic intraocular chondrosarcoma in a dog

Chondrosarcoma accounts for about 10% of all canine bone tumors and is the second most common primary bone tumor in dogs. In veterinary medicine, chondrosarcomas are classified as skeletal and extraskeletal. Extraskeletal chondrosarcomas are mesenchymal neoplasms of soft tissues and visceral organs that produce neoplastic chondrocytes in a fibrillary matrix. There is no involvement of bone or periosteal tissues in extraskeletal chondrosarcomas. The aim of this report is to describe the first case of a metastatic intraocular extraskeletal chondrosarcoma in a dog.     

Renal carcinoma as a cause of sudden death in an aged horse

This report describes rupture of a primary renal carcinoma as a cause of sudden death of an aged horse that presented with mild clinical signs of colic. The case is considered in the context of the few reported cases in the veterinary literature. The most striking feature of this case was the absence of prodromal signs prior to a catastrophic rupture of the tumour during a diagnostic work‐up.